Refinements in the small details of instituting cardiopulmonary bypass enable this surgical procedure to progress more smoothly, prevents occasional but often troublesome complications, and allows the surgeon to concentrate on less routine problems.
Insertion, positioning, and securing the caval catheters is a "standard" maneuver. The following modifications have made easier placement and removal of these catheters.
The catheter is first "formed" into a right angle by autoclaving the catheter in the metal catheter former* (Fig 1). The plastic will maintain this shape on cooling and removal. The metal formers prevent wall "kinking" and obstruction of the lumen of the catheter at the right angle. This shape of catheter has proved much easier to insert into the cava openings. The two catheters then lay side by side to the Y connector. This enables a "smooth lie" on the operative field.
The major problem after positioning of the caval catheters is to
GRISMER JT, LILLEHEI CW. Caval Catheter ModificationsOpen-Heart Surgery. Arch Surg. 1964;89(6):1111–1112. doi:10.1001/archsurg.1964.01320060179032
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